Pharmacy Garbage Help!
Jim Sedlak
Description
Collection
Title:
Pharmacy Garbage Help!
Creator:
Jim Sedlak
Date:
6/26/2014
Text:
I just met with a patient that was fit with an off the shelf AFO about a
month ago from the local pharmacy in her hometown. This brace does not come
close to fitting her properly at all. She is very short and is over weight.
The brace is too tall, and the foot plate is way to narrow. She indicates
that the pharmacy just gave her the brace and they did not even attempt to
fit it, instead letting her try it herself with the help of Physical
Therapy. The pharmacy has since billed her Medicare. Her doctor called me
directly with this problem and wants me to fit her with a custom AFO. I
don't know how to go about this and to still get reimbursed by Medicare.
She would actually be a great candidate for a Walk-on AFO from Otto Bock or
similar. However, I don't think that is an option since she has already
been billed in the last month with some garbage that does not fit. I am
wondering if we do provide a custom AFO if it will be covered or not, and
what type of additional documentation would you be looking for?
I am looking for any advice prior to me doing too much and going in the
wrong direction. How would any of you proceed with this situation? I am
just too tired and broke to work for free anymore.
Thanks in advance,
Jim Sedlak, CP, BOCO
Prosthetic HealthCare Services
month ago from the local pharmacy in her hometown. This brace does not come
close to fitting her properly at all. She is very short and is over weight.
The brace is too tall, and the foot plate is way to narrow. She indicates
that the pharmacy just gave her the brace and they did not even attempt to
fit it, instead letting her try it herself with the help of Physical
Therapy. The pharmacy has since billed her Medicare. Her doctor called me
directly with this problem and wants me to fit her with a custom AFO. I
don't know how to go about this and to still get reimbursed by Medicare.
She would actually be a great candidate for a Walk-on AFO from Otto Bock or
similar. However, I don't think that is an option since she has already
been billed in the last month with some garbage that does not fit. I am
wondering if we do provide a custom AFO if it will be covered or not, and
what type of additional documentation would you be looking for?
I am looking for any advice prior to me doing too much and going in the
wrong direction. How would any of you proceed with this situation? I am
just too tired and broke to work for free anymore.
Thanks in advance,
Jim Sedlak, CP, BOCO
Prosthetic HealthCare Services
Citation
Jim Sedlak, “Pharmacy Garbage Help!,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/236471.
